Information Collection Request

NCUA Personnel Security Processing Forms

ICR 202511-3133-001 · OMB 3133-0201 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1092 Personnel Security Data Form-Employee Form and Instruction Modified Repair queued
Form 1092 Personnel Security Data Form-Employee Form and Instruction Modified Available
Form 1093 Credit Release Form and Instruction Modified Repair queued
Form 1093 Credit Release Form and Instruction Modified Missing upstream
Form 1092C Personnel Security Data Form-Contractor Form and Instruction Modified Repair queued
Form 1092C Personnel Security Data Form-Contractor Form and Instruction Modified Repair queued
3133-0201_SS_10.2025_CLEAN.docx Supporting Statement A Uploaded 2025-11-13 Repair queued
3133-0201_SS_10.2025_CLEAN.docx Supporting Statement A Uploaded 2025-11-13 Available
IC Document Collections
IC IDCollectionTypeStatusForm
236447 Personnel Security Data Form-Employee Form and Instruction ModifiedPersonnel Security Data Form-Employee
236447 Personnel Security Data Form-Employee Form and Instruction Modified
236446 Credit Release Form and Instruction ModifiedCredit Release
236446 Credit Release Form and Instruction Modified
236445 Personnel Security Data Form-Contractor Form and Instruction ModifiedPersonnel Security Data Form-Contractor
236445 Personnel Security Data Form-Contractor Form and Instruction Modified
ICR Details
3133-0201 202511-3133-001
Active 202210-3133-001
NCUA OCSM
NCUA Personnel Security Processing Forms
Extension without change of a currently approved collection   No
Regular
Approved without change 05/08/2026
Retrieve Notice of Action (NOA) 11/17/2025
  Inventory as of this Action Requested Previously Approved
05/31/2029 36 Months From Approved 05/31/2026
1,200 0 1,200
200 0 200
0 0 0

Title 5, Code of Federal Regulations, Part 731 (suitability), Executive Order (E.O.) 13764 (contractor fitness), E.O. 12968/SEAD 4 (classified access), and Homeland Security Directive-12 (badging) requires all federal and contractor employees to undergo a background investigation when seeking employment with an agency. The NCUA Personnel Security Processing Forms (Personnel Security Data Form-Contractor, Personnel Security Data Form-Employee and the Authorization for Release of Credit Information) are used to collect information necessary for applying the government-established suitability/fitness criteria on employees before they can begin employment with or perform contractual services for the NCUA. It may be also required should a contract employee be moved to a new contract work. The background investigation process culminates in an adjudicative determination on whether or not these employees are fit to perform services on behalf of the agency.

EO: EO 12968 Name/Subject of EO: Classified Access
   EO: EO 13764 Name/Subject of EO: Contractor fitness
  
None

Not associated with rulemaking

  90 FR 41419 08/25/2025
90 FR 51411 11/17/2025
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,200 1,200 0 0 0 0
Annual Time Burden (Hours) 200 200 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$691,825
No
    Yes
    Yes
No
No
No
No
Amy Sa'id 703 548-2690 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/17/2025